Navigating Government Program Requirements for HRA

For government-sponsored health plans, the health risk assessment (HRA) is not only a critical tool to identify a member’s needs through risk stratification but a program requirement. Completion rates for HRAs are reported or counted in various quality rating...

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News Summary 7.07.18

News Summary 7.07.18

CMS.Gov: CMS taking action to modernize Medicare home health -- The Centers for Medicare & Medicaid Services (CMS) announced plans to “strengthen and modernize Medicare” by focusing “on individual patient needs rather than volume of care.” The...

News Summary 6.29.18

News Summary 6.29.18

HealthPayerIntelligence: Low customer satisfaction for Medicare Advantage --Uncoordinated communication and little help managing expenses led to low customer satisfaction for Medicare Advantage. With the 7.5 percent growth in the Medicare Advantage...

Medicare Advantage Plans at Start of Data Tsunami

Medicare Advantage Plans at Start of Data Tsunami

CMS Administrator Seema Verma announced in April that the agency has released Medicare Advantage encounter data to researchers. (Encounter data are records of the health care services for which managed care organizations pay.)  It was reported that...

1/100th of a Star Rating Point Could Mean Survival

1/100th of a Star Rating Point Could Mean Survival

Some Medicare Advantage plans scored a 3.74 and were rounded to the “nearest half Star” based on Centers for Medicare & Medicaid Services (CMS) rules, so the plan was rated a 3.5.  Conversely, other plans were scored 3.75 and were rounded to...